CT引导下经皮肺穿刺活检在中央型肺癌诊断中应用.docVIP

CT引导下经皮肺穿刺活检在中央型肺癌诊断中应用 　　[摘要] 目的 探讨CT引导下经皮肺穿刺活检对中央型肺癌诊断中的应用及并发症的预防。方法 对29例经纤维支气管镜检查未确诊或无法接受纤维支气管镜检查的中央型占位病变患者行CT引导下经皮肺穿刺活检。对其穿刺成功率、组织病理学阳性率及并发症的发生进行回顾性分析。结果 29例中，穿刺成功率为100%，组织病理学阳性率为100%。其中鳞癌15例，小细胞癌4例，腺癌4例，腺鳞癌6例。并发症发生率：气胸13.8%，针道出血10.3%，咳血3.4%。 结论 CT引导下经皮肺穿刺活检术对纤维支气管镜检查阴性或无法接受纤维支气管镜检查的中央型肺癌诊断，是一种高效、准确、微创的定性诊断方法。 　　[关键词] 中央型肺癌； CT引导； 穿刺活检； 体层摄影术；X线计算机 　　[中图分类号] R734.2[文献标识码] B[文章编号] 1673-9701（2014）16-0087-03 　　 　　Application of CT-guided percutaneous transthoracic biopsy in the diagnosis of central lung cancer 　　SUN Huiyu1 PIAO Xiangmao2 LI Xiangguo1 AN Hujie3 LIU Yang1 　　1.Department of Radiology，Yanbian Tumor Hospital，Yanji 133000，China；2.Department of Chemotherapy，Yanbian Tumor Hospital，Yanji 133000，China；3.Rehabilitation Department，Yanbian Tumor Hospital，Yanji 133000，China 　　[Abstract] Objective To investigate the clinical value of CT-guided percutaneous transthoracic biopsy in the diagnosis of central lung cancer. Methods CT-guided percutaneous transthoracic was performed in 29 patients with central lung cancer whom had not confirmed pathologically or can’t comply with fiberoptic bronchoscopy. The success rate of CT-guided percutaneous transthoracic biopsy， positive rate of histopathology and complications were analyzed retrospectively. Results In these 29 cases， diagnosis accuracy rate was 100%， positive rate of histopathology was 100%， including 15 cases of squamous cell carcinoma， 4 cases of small cell carcinoma， 4 cases of adenocarcinoma， 6 cases of adenosquamous carcinoma， 4 cases of postoperative pneumothorax， 3 cases of pulmonary hemorrhage， 1 cases of hemoptysis were found. Conclusion CT-guided percutaneous transthoracic is an effective， exact and less invasive technique in diagnosis of central lung cancer. 　　[Key words] Central lung cancer； CT-fluoroscopy；Percutaneous lung biopsy； Tomography； X-ray computed 肺部病变种类繁多，CT检查虽然大部分提示良恶性，但不能明确病理类型，对临床后续治疗带来一定局限性。纤维支气管镜检查及CT引导下肺穿刺活检术是目前被公认的得到肺部病变病理结果的最有效方法[1]，尤其是对纤维支气管镜达不到的肺周围性病变，CT引导下肺穿刺活检是一种安全、经济、